About BCDA
Beneficiary Claims Data API (BCDA) was released in February 2019 to share Medicare claims data with Accountable Care Organizations (ACOs) and other eligible model entities.
Similar to Claim and Claim Line Feed (CCLF) files, BCDA offers Medicare Parts A, B, and D data, but with some key differences in formatting and update frequency. Read more about using one or both data sources, or map data between sources using the Data Dictionary .
Claims data process
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Medicare enrollee receives care
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Provider submits Medicare claim
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BCDA shares partially adjudicated claims data
2-4 days after submission
Partially adjudicated claims haven’t been fully processed and approved yet. BCDA updates this data daily from the Fiscal Intermediary Standard System (FISS) and Multi-Carrier System (MCS).
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Medicare approves the claims
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BCDA shares adjudicated claims data
Typically 14 days after submission
BCDA receives updated adjudicated claims data from the Chronic Conditions Data Warehouse (CCW) every weekend. In the event of a delay, we'll make an announcement in the BCDA Google Group with updates on when the data will be refreshed.
Access partially adjudicated claims data with BCDA
| Partially adjudicated claims | Fully adjudicated claims |
|---|---|
| Update daily | Update weekly |
| Available to ACO REACH participants only | Available to all eligible model entities |
| Requires v2 | Available with v1 or v2 |
| Partially Adjudicated Claims Data Dictionary | BCDA Data Dictionary |
Read the guide to partially adjudicated claims and their use cases to learn more.
What are the other CMS claims-based FHIR APIs?
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Claims Data to Part D Sponsors
The AB2D API provides stand-alone Prescription Drug Plan sponsors with claims data to enhance the use of medication and improve the long term health of enrollees.
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Blue Button 2.0
The Blue Button 2.0 (BB2.0) API enables enrollees to connect their Medicare claims data to the applications, services, and research programs they trust.
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Data at the Point of Care
The Data at the Point of Care (DPC) API enables healthcare providers with claims data to fill in gaps in patient history at the point of care and deliver high-quality care to Medicare enrollees.
